Comparison of acromio axillary sternal notch index, thyromental height test, and modified mallampati test in preanesthetic prediction of difficult laryngoscopy

Introduction: The unanticipated difficult airway is a challenge to anaesthesiologists owing to the un-desirable respiratory and cardiac outcomes and other related complications. Three different predictors have been used, which include a Modified Mallampati Test, Thyromental Height Test, and the newly proposed Acromio Axillary Sternal Notch Index. In this study, we aim to compare the validity of the Acromio Axillary Sternal Notch Index, Thyromental Height Test and the Modified Mallampati Test as preanesthetic predictors of difficult laryngoscopy. Methodology: Patient's demographics were assessed and physical examination were carried out based on the predictive tools Modified Mallampati Test, Thyromental Height Test, Acromio Axillary Sternal Notch Index.Results: The majority of the patients in this study were <60yrs of age. Out of 358 participants, 57.5% were females and 42.5% were males. Our study shows an incidence of 24.6% for difficult laryngoscopy. The study reveals that the Thyromental Height Test examination had high specificity compared to the Modified Mallampati Test examination, but the ability to predict true difficult laryngoscopy was less when compared to Modified Mallampati Test. The new predictor, Acromio Axillary Sternal Notch Index, had high sensitivity and high positive predictive compared to the other two predictors, Modified Mal-lampati Test and Thyromental Height Test.Conclusion: The study concludes that the Acromio Axillary Sternal Notch Index is an ideal standalone preanesthetic predictor of difficult laryngoscopy based on its high sensitivity and high positive predictive value.(c) 2022 Elsevier Ltd. All rights reserved.